Heart defect shouldn't limit kids' exercise: study

NEW YORK (Reuters Health) - Children born with a hole between the left and right sides of the heart - what doctors call a ventricular septal defect -- are generally as healthy and physically fit as other children and should not be discouraged from engaging in strenuous exercise, a Dutch research team has found.

"It is useful and important to determine appropriately safe and effective exercise levels for various congenital heart disease subgroups so that recommendations can be tailored accordingly," Dr. Mathijs Binkhorst and colleagues at Radboud University Nijmegen Medical Centre write in the American Journal of Cardiology.

They combined exercise testing, activity monitoring and a questionnaire to see whether or not children with ventricular septal defect fall short in their capacity to exercise compared to their healthy peers, and also whether or not these children partake in the same activities as their healthy peers.

Specifically, they compared cardiovascular and pulmonary function and physical fitness in 27 children with isolated ventricular septal defects and 15 healthy control children. All of the children were between 8 and 17 years old.

Thirteen of the children had a clinically relevant defect that had been surgically closed, while in the other 14 affected children, the defect was smaller and was still present or had spontaneously closed.

After adjusting for weight and body fat, the investigators found that the capacity to exercise and the amount of energy expended in exercise was not significantly different between children with and without a history of ventricular septal defect.

"Contrary to one's common sense and intuition, children with a moderately severe congenital heart defect -- some of whom even had open-heart surgery -- are capable of exercising with the same intensity and endurance as children with an uneventful medical history," Binkhorst told Reuters Health.

Moreover, this study does not substantiate the "commonly reported occurrence of overprotection in children with congenital heart disease," the investigators note.

"Apparently, children with ventricular septal defect are as physically active as healthy peers and they do not refrain from physically demanding chores, jobs, games, sports, or means of transportation," they add.

The investigators emphasize, however, that this study cohort had relatively mild heart defects, and that results are likely to differ among children with more complex cardiac defects.

SOURCE: American Journal of Cardiology, October 15, 2008.